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Feb 7, 2011

Treating 1361 Poor Tuberculosis Patients in India

Living conditions in areas where OpASHA works
Living conditions in areas where OpASHA works

Performance Snapshot

Number of centers operating: 23

New centers opened in the period Nov 2010-Jan 2011: 6

Total number of patients at centers: 324

Total new patients enrolled in the period Nov 2010-Jan 2011: 158

Total patients who have completed treatment and/or cured: 53

Total number of volunteers trained: 3 Counselors (working full time with Operation ASHA), and 6 Community DOTs Providers (working part time)

Total number of Home Visits: 4145

Total number of individuals made aware: 24870

Total number of contacts: 790

Impact till date

Following is the list of tangible impact made by OpASHA


  1. 150,000 Disadvantaged slum-dwellers educated about TB, and the stigma attached to TB reduced.
  2. 324 TB patients are under treatment. Treated persons regain strength and can resume normal lives.
  3. Spread of infection to 3888 persons prevented.
  4. 350 painkillers, 400 antiemmetic tablets, 700 iron tablets, 350 calcium tablets, 150 sachets of ORS, and 50 blankets were distributed, helping thousands of patients and their families.

II. LIVELIHOOD GENERATION: 9 persons from the slums have been employed by OpASHA, 3 full-time and 6 part-time. It may be mentioned here that 80% of OpASHA’s expenses generate livelihood in the slums.


  1. 324 adult patients are receiving TB treatment. TB treatment reinstates the productivity of the patients. Each patient earns an additional Rs. 6,000 per year after treatment for her lifetime (Government of India). This is equivalent to an annuity of Rs. 75,000 a huge amount for people earning Rs. 50 a day or less.
  2. For 3888 infections prevented, OpASHA has saved the Indian economy Rs. 58 million providing indirect benefits to millions of slum-dwellers.
  3. OpASHA delivers Social Return on Investment of 11718%. For each Rupee donated to OpASHA, society gains benefits worth Rs. 117. This indirectly helps improve the lives of millions of slum-dwellers.

Documented Improvements

The population of 150,000 in slums that has been served by this project is now much more aware of the symptoms of TB. They also feel lower stigma and are accepting the fact that TB is not a terminal disease. So many more suspects are coming up for testing. Once tested and diagnosed positive, the patients are more willing to join the therapy. This is helping ensure “early and increased detection”, which is one of the major goals prescribed by WHO. This goal is thus being effectively achieved by the Project.

One such case was of Mohan, a 7 years old student.  He was diagnosed with TB at the district TB hospital, where he was found to be seriously ill and tested positive on a sputum test.  He came to Operation ASHA extremely weak and malnourished.

Our counselor immediately started him on treatment.  Our counselor explained the details of TB treatment, transmission, and prevention to Mohan and told that if he took his medication regularly, he will soon be fine soon. Also, looking at his condition, Operation ASHA decided to support Mohan by giving her free food and nutrition for her entire treatment period.

Two months after beginning treatment, he was able to continue her studies—rather than being kicked out of school, which is a sadly common occurrence for students who contract TB.  Now healthy and in the last months of treatment, Mohan comments on his treatment: The counselor makes me laugh – by talking and laughing with me. 

Many other disadvantaged slum dwellers, like Mohan, have benefitted from this project. Thank you for your contribution.

Best Practices learnt during the project.

  1. A major challenge is connecting with the people that we are working to treat and educate, as well as gaining their trust.  The solution that we have used for this is to get our counselors from the areas in which they are working.  Thus, they know the areas, customs, dialects etc. of the slums they are working in.  This practice makes it much easier to gain the trust and respect of the communities that we are trying to serve.
  2. The major problem of treating TB is that the treatment takes over 6 months and must be done properly or default will occur and likely result in the often fatal Multi-drug-resistant TB (MDR) and Extensively-Drug-Resistant TB (XDR).  Thus, accessibility of centers is key. Operation ASHA has solved this problem with its innovative management of the supply chain by taking TB treatment to the doorsteps of the disadvantaged. It provides a dense network of treatment centers that are established within the community, e.g. in small shops, huts and in the premises of local health providers. They are open for long hours from early in the morning to late in the evening, allowing patients to procure the medicine conveniently without spending money on transport or losing wages.
  3. Another major challenge of TB treatment is making sure that patients and families understand the risks of defaulting.  Thus, OpASHA combines extensive education with our treatment, to both the patients and their families.  This treatment occurs not only at the beginning of our work with patients, but also if there are any problems or missed doses a counselor will give them educational reminders.
  4. A huge challenge of treating TB also lies in the stigma attached to it.  Employees often loose their jobs, and wives and children are often kicked out of the home.  Thus, OpASHA also acts as an advocate for its patients when necessary—appealing to employers, and families for the protection of the patients we treat.
  5. The other problem with the stigma is the reaction that people might have towards our patients if they are going to OpASHA clinics for treatment.  Thus our clinics and counselors are presented as offering additional services to the community.  The location of clinics is linked to temples, other health suppliers, etc. so that any patient entering our center does not have to fear being associated with the TB stigma.  Our counselors also offer other services, such as: food products, protein supplements, ORS, over-the-counter drugs, iron tablets for pregnant women, contraceptives for birth spacing, blankets, and much more.
  6. A final problem is in up keeping the quality of our services. To ensure the top service OpASHA practices rigorous quality control, and has established a robust feedback loop that involves government staff, WHO, and other nonprofits and community leaders.  Our counselors are also given incentive based salaries to ensure the lowest default rate and highest detection rate possible.
OpASHA DOTs Center
OpASHA DOTs Center
A child getting Directly Observed Therapy
A child getting Directly Observed Therapy
OpASHA's counselor at DOTS center
OpASHA's counselor at DOTS center
An old TB patient
An old TB patient
Home of a TB patient
Home of a TB patient
A typical slum where our beneficiaries live
A typical slum where our beneficiaries live


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